Ethical Treatment after Rape

While I fully agree with the Catholic Church' s teaching against abortion, what is the moral teaching regarding the rape of a woman and the treatment of rape?

The Catechism offers a clear moral teaching:

"Rape is the forcible violation of the sexual intimacy of another person.
It does injury to justice and charity. Rape deeply wounds the respect, freedom,
and physical and moral integrity to which every person has a right. It causes
grave damage that can mark the victim for life. It is always an intrinsically
evil act. Graver still is the rape of children committed by parents (incest) or
those responsible for the education of the children entrusted to them." (no.
2356) Note that rape is "an intrinsically evil act," meaning that it
is evil at its very root, nothing justifies it, and it is objectively a mortal
sin.

If a woman is raped, even though she may fear exposing herself to shame
and notoriety, she should seek proper medical care as soon as possible. Such care
must be extremely sensitive and compassionate.

In accord with the Ethical
and Religious Directives for Catholic Health Care Services (no. 36), the care
for the rape victim has four aspects: First, she must receive spiritual and psychological
support and counseling to help her deal with the trauma of the attack. Such support
and counseling will probably continue for some time after the immediate period.

Second,
health care providers need to cooperate with law enforcement officials, gathering
evidence that can be used in the prosecution of the rapist.

Third, the victim
needs treatment for bruises, cuts, or other injuries.

Finally, health care
providers must provide treatment to prevent the possible contraction of venereal
disease and pregnancy. The Directives state, "A woman who has been
raped may defend herself against a conception resulting from sexual assault. If,
after appropriate testing, there is no evidence that conception has occurred already,
she may be treated with medication that would prevent ovulation, sperm capacitation,
or fertilization. It is not permissible, however, to initiate or to recommend
treatments that have as their purpose or direct effect the removal, destruction,
or interference with the implantation of a fertilized ovum."(no. 36)

The
woman who is a victim of rape has the moral right to prevent the pregnancy for
the following reasons: First, the rapist (including his sperm) is an unjust aggressor
who has violated the woman's dignity.
Second, rape is an act of force and violence, unlike the conjugal love in marriage
whereby both spouses give freely of themselves in an act of unitive and procreative
love. Third, the woman is not responsible for the action, and thereby has the
right to prevent the pregnancy. (Please note that for these three reasons, this
guidance does not violate the Church' s teaching regarding contraception as
expressed in Humanae Vitae, which, because of the free-giving between spouses,
stated, "Each and every marriage act must remain open to the transmission
of life (no. 11).)

In preventing pregnancy, most rape treatment protocols
recommend anti-fertility drugs to be administered within 72 hours and over a period
of several days. These drugs, such as Ovral, inhibit ovulation. However, some
contraceptives may also affect the endometrium of the uterus, causing the expulsion
of a conceived ovum. This latter effect is problematical.

The real difficulty
in rape treatment protocols is having moral certainty (not absolute but the best
possible, good faith, certainty one can have) that conception has not occurred,
for once conception has occurred, the new life has a right to life and must be
protected. The Second Vatican Council asserted, "Life must be protected with
the utmost care from the moment of conception: abortion and infanticide are abominable
crimes."(Gaudium et Spes, no. 51) Subsequently, the Declaration
on Procured Abortion (1974) affirmed that life is sacred from conception and
that directly intended abortion is an intrinsically evil act: "From the time
the ovum is fertilized, a life is begun which is neither that of the father nor
of the mother; it is rather the life of a new human being with his own growth.
It would never be made human if it were not human already"(no. 12). Not only
does this new life have physical integrity, it also has a soul, created and infused
by Almighty God. This unique human being, with both body and soul, has a right
to life no matter who he is or how he was conceived.

For this reason, The
Ethical and Religious Directives for Catholic Health Facilities state, "Abortion,
that is the directly intended termination of pregnancy before viability, is never
permitted nor is the directly intended destruction of a viable fetus. Every procedure
whose sole immediate effect is the termination of pregnancy before viability is
an abortion, which, in its moral context, includes the interval between conception
and implantation of the embryo" (no. 12). Therefore, abortifacients —

those drugs which would cause the expulsion of a conceived ovum — are morally
wrong.

Therefore, before administering contraceptives to a rape victim,
health care providers must ascertain first her medical history (including menstrual
history, recent sexual activity, and contraceptive usage). A pregnancy test should
be performed. If she is not pregnant but her medical history suggests the possibility
that ovulation may have occurred, then health care providers ought to administer
a Luteinizing Hormone urine dip test or a progesterone blood level test. These
tests would indicate if ovulation has indeed occurred and thereby a child was
possibly conceived. If these tests are not available in a timely way or at all,
treatment should proceed as long as there is a reasonable doubt that ovulation
has occurred.

Here again is a key point. If there is a reasonable certainty
that ovulation has not taken place, and there is reasonable certainty that it is not just about to occur, (as would be indicated by a test showing that the Leutinizing Hormone [LH] surge had not occurred) then one may proceed with treatment. If, on other hand, the LH surge has been detected, the "morning after" pill ought not be given, as ovulation is about to occur, is occurring, or has already just occurred. If there is certainty that ovulation has occurred and conception
may have taken place, then the child has the right to life and the mother must
not risk an abortion from the antifertility drugs. (See here for more on this)

On this latter point,
some may have difficulty with the situation of a woman carrying to birth a child
conceived through rape. Even though studies indicate a 0-2.2 percent occurrence
of pregnancy due to rape (Abortion: The Hard Cases), the fact remains pregnancies
do occur. We must never forget that the child is an innocent human being, made
in the image and likeness of God, who did not ask to be conceived.

Also,
as Christians, we bear the cross and suffer for the love of God. Consequently,
a mother in such a case must love as Christ would truly love, and give life to
the innocent child. For a mother who is the victim of the violence of an unjust
aggressor to take the life of an innocent unborn child would make her now the
unjust aggressor. As our Holy Father Pope John Paul II taught, whatever the reason
for abortion, "however serious or tragic, can never justify the deliberate
killing of an innocent human being."(Evangelium Vitae, no. 58) Instead,
the faithful must support the woman who is the tragic victim and, if she has conceived,
her child.

Acknowledgement

This article is reprinted with permission from Arlington
Catholic Herald.

The Author

Father William Saunders is pastor of Our Lady of Hope parish in Potomac Falls, Virginia. He is dean of the Notre Dame Graduate School of Christendom College. The above article is a "Straight Answers" column he wrote for the Arlington Catholic Herald. Father Saunders is the author of Straight Answers, a book based on 100 of his columns, and Straight Answers II.